Near Miss Reporting

A near miss is a potential hazard or incident that has not resulted in any personal injury, illness, or
damage. Unsafe working conditions, unsafe employee work habits, improper use of equipment,
and use of malfunctioning equipment have the potential to cause work related injuries. It is
everyone’s responsibility to report and/or make the necessary corrections, immediately, to the
unsafe environment and/or practice.

This Near Miss Reporting System is a voluntary, confidential, non-punitive, and secure reporting
system. It has been created with the goal of improving safety at Boston University (BU) and
Boston Medical Center (BMC). Submitted reports will be reviewed by Environmental Health and
Safety (EHS) staff. You may submit reports anonymously if desired. As appropriate, near misses
will be investigated to the extent possible with findings and any corrective actions being posted on
the EHS website for other BU and BMC community members to use as a learning tool.

If an injury occurred, it should be reported through other channels. See the Accident and
Incident Reporting webpage for information regarding injuries. If there is an
immediate emergency, please contact:

• Charles River Campus (CRC): Boston University Police at 617-353-2121

• Boston University Medical Center (BUMC): Public Safety at 617-414-4444

Additionally, please consult the Emergency Response Flip-Chart.

Please complete this form as a means to report near miss situations, report safety concerns,
or make suggestions regarding safety.

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  • If you wish to be contacted or require follow-up, please include your name.
  • If you wish to be contacted or require follow-up, please include your phone number.
  • If you wish to be contacted or require follow-up, please include your e-mail address.
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  • Please be as descriptive as possible and include the building name/number and room name/number if applicable. Please provide additional location information and address information in the box below (including additional addresses).
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  • Please describe, in detail, the near miss or incident that took place.
  • Please describe, in detail, the possible adverse effects, outcome, and/or impact of the near miss or incident.
  • Please provide any additional information, questions, comments, and/or concerns.